J Endocrinol Metab

Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc

Journal website https://www.jofem.org

Original Article

Volume 14, Number 5, October 2024, pages 221-225

The Cardiometabolic Clinic: Bridging Gaps in Care

**Table 1.** Baseline Patient Characteristics in the Cardiometabolic Clinic Patients and Controls
Characteristic	Cardiometabolic clinic patients	Primary care controls	P
^aNumbers in percent column represent standard deviation.
Total	65 (100)	65 (100)
Mean age^a, years	66.3 (9.6)	64.3 (9.8)	0.18
Sex, female	21 (32.3)	21 (32.3)	0.57
Race, White	59 (90.1)	63 (96.9)	0.24
Non-Hispanic	63 (96.9)	62 (95.4)	1.00
Insurance
Medicare	29 (44.6)	31 (47.7)	0.73
Commercial	29 (44.6)	25 (38.5)	0.48
Medicaid	4 (6.2)	4 (6.2)	1.00
None	1 (1.5)	3 (4.6)	0.62
Other	3 (4.6)	0 (0)	0.24
Smoking
Current	5 (7.7)	13 (20)	0.11
Former	37 (56.9)	29 (44.6)
Never	23 (35.4)	23 (35.4)
Heart failure
None	24 (36.9)	37 (56.9)	0.09
Heart failure reduced ejection fraction (HFrEF)	19 (29.2)	14 (21.5)
Heart failure mid-range ejection fraction (HFmEF)	7 (10.8)	2 (3.1)
Heart failure preserved ejection fraction (HFpEF)	15 (23.1)	12 (18.5)
Coronary artery disease history	51 (78.5)	56 (86.2)	0.18
Chronic kidney disease history	25 (38.5)	11 (16.9)	0.01
Body mass index (BMI)^a, mean kg/m²	37.1 (13.0)	35.3 (11.1)	0.35
Hemoglobin A1c^a, mean %	7.8 (1.6)	7.7 (2.0)	0.24
Estimated glomerular filtration rate (eGFR)^a, mean mL/min/1.73 m²	73.3 (27.5)	75.8 (26.3)	0.59
Low-density lipoprotein (LDL)^a, mean mg/dL	72.2 (32.2)	79.3 (30.1)	0.15
Systolic blood pressure^a, mean mm Hg	133.2 (17.5)	129.7 (20.9)	0.22
Diastolic blood pressure^a, mean mm Hg	67.5 (8.8)	72.2 (10.3)	0.01

Table 1. Baseline Patient Characteristics in the Cardiometabolic Clinic Patients and Controls

Characteristic

Cardiometabolic clinic patients

Primary care controls

N (%)

^aNumbers in percent column represent standard deviation.

Total

65 (100)

Mean age^a, years

66.3 (9.6)

64.3 (9.8)

0.18

Sex, female

21 (32.3)

0.57

Race, White

59 (90.1)

63 (96.9)

0.24

Non-Hispanic

63 (96.9)

62 (95.4)

1.00

Insurance

Medicare

29 (44.6)

31 (47.7)

0.73

Commercial

29 (44.6)

25 (38.5)

0.48

Medicaid

4 (6.2)

1.00

None

1 (1.5)

3 (4.6)

0.62

Other

3 (4.6)

0 (0)

0.24

Smoking

Current

5 (7.7)

13 (20)

0.11

Former

37 (56.9)

29 (44.6)

Never

23 (35.4)

Heart failure

None

24 (36.9)

37 (56.9)

0.09

Heart failure reduced ejection fraction (HFrEF)

19 (29.2)

14 (21.5)

Heart failure mid-range ejection fraction (HFmEF)

7 (10.8)

2 (3.1)

Heart failure preserved ejection fraction (HFpEF)

15 (23.1)

12 (18.5)

Coronary artery disease history

51 (78.5)

56 (86.2)

0.18

Chronic kidney disease history

25 (38.5)

11 (16.9)

0.01

Body mass index (BMI)^a, mean kg/m²

37.1 (13.0)

35.3 (11.1)

0.35

Hemoglobin A1c^a, mean %

7.8 (1.6)

7.7 (2.0)

0.24

Estimated glomerular filtration rate (eGFR)^a, mean mL/min/1.73 m²

73.3 (27.5)

75.8 (26.3)

0.59

Low-density lipoprotein (LDL)^a, mean mg/dL

72.2 (32.2)

79.3 (30.1)

0.15

Systolic blood pressure^a, mean mm Hg

133.2 (17.5)

129.7 (20.9)

0.22

Diastolic blood pressure^a, mean mm Hg

67.5 (8.8)

72.2 (10.3)

0.01

**Table 2.** Overall Medication Changes at an Initial Visit to the Cardiometabolic Clinic (N = 65)^a
Characteristic	Cardiometabolic clinic patients
^aPatients often had more than one medication intervention.
No medication changes at visit	4 (6.2)
Discontinue	24 (40.0)
Dose increase	18 (27.7)
Dose decrease	15 (23.1)
Start a new medication	51 (78.5)

Table 2. Overall Medication Changes at an Initial Visit to the Cardiometabolic Clinic (N = 65)^a

Characteristic

Cardiometabolic clinic patients

N (%)

^aPatients often had more than one medication intervention.

No medication changes at visit

4 (6.2)

Discontinue

24 (40.0)

Dose increase

18 (27.7)

Dose decrease

15 (23.1)

Start a new medication

51 (78.5)

**Table 3.** Specific Medication Changes at an Initial Visit to the Cardiometabolic Clinic (N = 65)^a
	Start a new medication	Discontinue	Dose increase	Dose decrease
^aPatients often had more than one medication intervention.
Glucagon-like peptide-1 (GLP-1)	33	2	7	0
Sodium-glucose cotransporter-2 (SGLT2) inhibitor	16	5	1	0
Gastric inhibitory polypeptide (GIP) and glucagon-like peptide-1 (GLP-1)	4	0	0	0
Insulins-basal	3	4	4	9
Metformin	2	0	6	0
Insulins-bolus	1	6	1	2
Sulfonylureas	1	3	0	4
Dipeptidyl peptidase-4 (DPP-4) inhibitors/incretin enhancer	0	7	1	0

Table 3. Specific Medication Changes at an Initial Visit to the Cardiometabolic Clinic (N = 65)^a

Start a new medication

Discontinue

Dose increase

Dose decrease

^aPatients often had more than one medication intervention.

Glucagon-like peptide-1 (GLP-1)

Sodium-glucose cotransporter-2 (SGLT2) inhibitor

Gastric inhibitory polypeptide (GIP) and glucagon-like peptide-1 (GLP-1)

Insulins-basal

Metformin

Insulins-bolus

Sulfonylureas

Dipeptidyl peptidase-4 (DPP-4) inhibitors/incretin enhancer

**Table 4.** Follow-Up Diabetes Medication Regimens (N = 65 per Group)
Medication	Cardiometabolic clinic patients	Primary care controls	P
Glucagon-like peptide-1 (GLP-1)	41 (63.1)	16 (24.6)	0.000
Sodium-glucose cotransporter-2 (SGLT2) inhibitor	31 (47.7)	7 (10.8)	0.000
Insulins-basal	27 (41.5)	25 (38.5)	0.720
Metformin	26 (40.0)	29 (44.6)	0.594
Insulins-bolus	11 (16.9)	20 (30.8)	0.099
Sulfonylureas	10 (15.4)	8 (12.3)	0.612
Gastric inhibitory polypeptide (GIP) and glucagon-like peptide-1 (GLP-1)	3 (4.6)	0 (0.0)	0.244
Dipeptidyl peptidase-4 (DPP-4) inhibitors/incretin enhancer	2 (3.1)	6 (9.2)	0.273
Thiazolidinediones (TZD)	0 (0.0)	2 (3.1)	0.496

Table 4. Follow-Up Diabetes Medication Regimens (N = 65 per Group)

Medication

Cardiometabolic clinic patients

Primary care controls

N (%)

Glucagon-like peptide-1 (GLP-1)

41 (63.1)

16 (24.6)

0.000

Sodium-glucose cotransporter-2 (SGLT2) inhibitor

31 (47.7)

7 (10.8)

0.000

Insulins-basal

27 (41.5)

25 (38.5)

0.720

Metformin

26 (40.0)

29 (44.6)

0.594

Insulins-bolus

11 (16.9)

20 (30.8)

0.099

Sulfonylureas

10 (15.4)

8 (12.3)

0.612

Gastric inhibitory polypeptide (GIP) and glucagon-like peptide-1 (GLP-1)

3 (4.6)

0 (0.0)

0.244

Dipeptidyl peptidase-4 (DPP-4) inhibitors/incretin enhancer

2 (3.1)

6 (9.2)

0.273

Thiazolidinediones (TZD)

0 (0.0)

2 (3.1)

0.496

**Table 5.** Follow-Up Visit Diabetes Medication Regimen (N = 65 per Group)
Characteristic	Cardiometabolic clinic patients	Primary care controls	P
SD: standard deviation.
Body mass index (BMI), kg/m²	-2.8	5.2	-0.5	2.0	0.0001
Hemoglobin A1c, %	-0.9	1.8	-0.4	1.9	0.0155
Estimated glomerular filtration rate (eGFR), mL/min/1.73 m²	-1.95	12.9	0.51	16.0	0.22
Low-density lipoprotein (LDL), mg/dL	-4.8	23.8	-9.4	29.5	0.61
Systolic blood pressure, mm Hg	-5.4	19.4	-0.8	26.9	0.25
Diastolic blood pressure, mm Hg	2.4	12.1	-1	12.5	0.15

Table 5. Follow-Up Visit Diabetes Medication Regimen (N = 65 per Group)

Characteristic

Cardiometabolic clinic patients

Primary care controls

Mean

SD: standard deviation.

Body mass index (BMI), kg/m²

-2.8

5.2

-0.5

2.0

0.0001

Hemoglobin A1c, %

-0.9

1.8

-0.4

1.9

0.0155

Estimated glomerular filtration rate (eGFR), mL/min/1.73 m²

-1.95

12.9

0.51

16.0

0.22

Low-density lipoprotein (LDL), mg/dL

-4.8

23.8

-9.4

29.5

0.61

Systolic blood pressure, mm Hg

-5.4

19.4

-0.8

26.9

0.25

Diastolic blood pressure, mm Hg

2.4

12.1

-1

12.5

0.15